FRED MICHAEL ITVELDT (MSN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1619393204

FRED MICHAEL ITVELDT (MSN) is a healthcare provider. based in Spokane valley, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN. They hold a License No. AP60451837 (WA). The NPI Number for FRED MICHAEL ITVELDT (MSN) is 1619393204

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
FRED MICHAEL ITVELDT (MSN)
NPI
1619393204
Phone
(509) 868-0876
Address
1005 N PINES RD
Enumeration Date
6 March 2014
Last Update Date
28 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2086761003
Graduation Year
2013 (13 years ago)
PAC ID
4385867282
Group Practice PAC ID
9537434014
Professional Enrollment ID
I20160630000068
Address ID
ID838142613CO1105XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:12State licenses:2Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for FRED MICHAEL ITVELDT (MSN)

  • 1005 N PINES RD

    STE 310

    SPOKANE VALLEY, WA 992064958

    Phone: (509) 868-0876

    Fax: (509) 385-0670

    Type: Mailing

  • 12615 E MISSION AVE STE 310

    SPOKANE VALLEY, WA 992161047

    Phone: (509) 707-8581

    Fax: (509) 443-5269

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 42 Open Payments records for all available years, with a total value of $1,296.

Total Amount is formed as General ($1,296) + Research ($0) + Ownership ($0) = $1,296.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($243).

Total Amount

$1,296

General + Research + Ownership

Payments

42

Total payment records

General Amount

$1,296

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-06-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140522000203INurse PractitionerWATBD
I20160630000068INurse PractitionerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4718$0
90833Psychotherapy with evaluation and management visit, 30 minutes3213$0
View full utilization report →

Insurance plans in this area (ZIP 99206)

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Provider's Procedures

FRED MICHAEL ITVELDT (MSN) performs procedures in NURSE PRACTITIONER. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERWA90833Psychotherapy, 30 minutes with patient and/or family member4811

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537434014View full group profile
NameSpecialtyState
-ID
Nurse PractitionerID
Clinical Social WorkerID
Clinical Social WorkerID

Reviews

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Frequently asked questions

Can I verify FRED MICHAEL ITVELDT (MSN) with an NPI only?
You can start verification with NPI 1619393204 for FRED MICHAEL ITVELDT (MSN), then check state licensing separately.
Does the file indicate FRED MICHAEL ITVELDT (MSN) is practicing under active NPI?
Directory data currently reports FRED MICHAEL ITVELDT (MSN) as active.
What is FRED MICHAEL ITVELDT (MSN) best known for clinically?
Directory data describes FRED MICHAEL ITVELDT (MSN) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect FRED MICHAEL ITVELDT (MSN) on a map?
Expect Spokane Valley, Washington as a primary anchor for FRED MICHAEL ITVELDT (MSN) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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